Organization
HIDDEN PINE FAMILY PRACTICE INC
Active
Other names
Medical Practice
Organization subpart
No
Provider details
NPI number
Authorized official
ARTHUR OLIVEROS (PRESIDENT)
(331) 269-9896
Entity
Organization
Contact information
Practice address
3540 SEVEN BRIDGES DR STE 100, WOODRIDGE, IL 60517-1254
(331) 269-9896
(888) 388-0996
Mailing address
3540 SEVEN BRIDGES DR STE 100, WOODRIDGE, IL 60517-1254
(847) 420-9664
(888) 388-0996
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
Primary
—
—
363LP2300X
Primary Care Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
024794778
—
IL
Enumeration date
11/30/2022
Last updated
09/26/2023
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